Is polycystic ovary syndrome associated with high sympathetic nerve activity and size at birth?

Sverrisdóttir, Yrsa Bergmann; Mogren, Tove; Kataoka, Josefin; Janson, Per Olof; Stener-Victorin, Elisabet

doi:10.1152/ajpendo.00725.2007

Cited by 181 publications

(180 citation statements)

References 55 publications

Supporting

Mentioning

163

Contrasting

Order By: Relevance

“…This is supported by data showing dense ovarian innervation by catecholaminergic nerve fibers in women with PCOS (14,20,42). We suggest that the effect of acupuncture is at least in part mediated via modulation of both general and ovarian (peripheral) sympathetic activity (37,39,40).…”

Section: E939supporting

confidence: 74%

See 1 more Smart Citation

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Johansson

Redman

Veldhuis

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

Self Cite

114

View full text Add to dashboard Cite

Acupuncture has been demonstrated to improve menstrual frequency and to decrease circulating testosterone in women with polycystic ovary syndrome (PCOS). Our aim was to investigate whether acupuncture affects ovulation frequency and to understand the underlying mechanisms of any such effect by analyzing LH and sex steroid secretion in women with PCOS. This prospective, randomized, controlled clinical trial was conducted between June 2009 and September 2010. Thirty-two women with PCOS were randomized to receive either acupuncture with manual and low-frequency electrical stimulation or to meetings with a physical therapist twice a week for 10 -13 wk. Main outcome measures were changes in LH secretion patterns from baseline to after 10 -13 wk of treatment and ovulation frequency during the treatment period. Secondary outcomes were changes in the secretion of sex steroids, anti-Müllerian hormone, inhibin B, and serum cortisol. Ovulation frequency during treatment was higher in the acupuncture group than in the control group. After 10 -13 wk of intervention, circulating levels of estrone, estrone sulfate, estradiol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, testosterone, free testosterone, dihydrotestosterone, androsterone glucuronide, androstane-3␣,17␤-diol-3-glucuronide, and androstane-3␣,17␤-diol-17-glucuronide decreased within the acupuncture group and were significantly lower than in the control group for all of these except androstenedione. We conclude that repeated acupuncture treatments resulted in higher ovulation frequency in lean/overweight women with PCOS and were more effective than just meeting with the therapist. Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion. polycystic ovary syndrome; acupuncture; ovulation; lh pulsatility; sex steroids THE MAIN CHARACTERISTICS of polycystic ovary syndrome (PCOS) are polycystic ovaries (34), oligo/anovulation, and elevated serum levels of sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites (38). PCOS is related to hyperinsulinemia and insulin resistance and is exacerbated by obesity (7). Numerous studies have reported hypersecretion of luteinizing hormone (LH) in women with PCOS (3). Together with an exaggerated ovarian response, hypersecretion of LH drives excessive ovarian androgen production and causes anovulation (13). In PCOS, altered sex steroid production, metabolic dysfunction, and obesity all contribute to changes in LH secretion patterns and to anovulation (6,12,29,30).Clomiphene citrate, exogenous gonadotropin therapy, and laparoscopic ovarian drilling are commonly used to induce ovulation in women with PCOS (1). These treatments often have negative side effects, thus indicating the importance of evaluating alternative treatments such as acupuncture. Acupuncture is used worldwide to achieve fertility, but its efficacy is supported by only limited scientific evidence. In a randomized controlled trial (RCT), we previously demonstrated that acupuncture w...

show abstract

Section: E939supporting

confidence: 74%

“…Women with PCOS have generally high muscular sympathetic nerve activity that is associated with high circulating T (42). This is supported by data showing dense ovarian innervation by catecholaminergic nerve fibers in women with PCOS (14,20,42).…”

Section: E939mentioning

confidence: 65%

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Johansson

Redman

Veldhuis

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

Self Cite

114

View full text Add to dashboard Cite

show abstract

“…In rats an increased sympathetic tone seems essential for the existence and maintenance of PCOS, as restoration of cyclicity can be achieved by transsection of the sympathetic innervations (21,22,23,24). In humans there is also evidence that PCOS is associated with an increased sympathetic nerve activity compared with controls (25). It is well known that PCOS patients have more central obesity, an increased chance of developing hypertension and other cardiovascular diseases and diabetes.…”

Section: Neuronal Pathwaysmentioning

confidence: 99%

Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women

Hendriks¹,

König

Soleman

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Little is known about the function of the ovarian neuronal network in humans. In many species, copulation influences endocrinology through this network. As a first step, the possible influence of ovarian mechanical manipulation on pituitary and ovarian hormones was evaluated in polycystic ovarian syndrome (PCOS) and regularly cycling women. Design: Prospective case-control study (2008)(2009)(2010). Methods: Ten PCOS women (Rotterdam criteria) undergoing ovulation induction with recombinant-FSH and ten normal ovulatory controls were included in an academic fertility clinic. In the late follicular phase blood was drawn every 10 min for 6 h. After 3 h the ovaries were mechanically manipulated by moving a transvaginal ultrasound probe firmly over each ovary ten times. Main outcome measures were LH and FSH pulsatility and ovarian hormones before and after ovarian manipulation. Results: All PCOS patients showed an LH decline after the ovarian manipulation (before 13.0 U/l and after 10.4 U/l, P!0.01), probably based on a combination of a longer LH pulse interval and smaller amplitude (PZ0.07). The controls showed no LH change (before 9.6 U/l and after 9.3 U/l, PZ0.67). None of the ovarian hormones (estradiol, progesterone, anti-Mü llerian hormone, inhibin B, androstenedione and testosterone) changed in either group. Conclusions: Ovarian mechanical manipulation lowers LH secretion immediately and typically only in preovulatory PCOS patients. The immediate LH change after the ovarian manipulation without any accompanying ovarian hormonal changes point to nonhormonal communication from the ovaries to the pituitary. A neuronal pathway from the ovaries communicating to the hypothalamic-pituitary system is the most reasonable explanation.

show abstract

“…91 Naltrexone is an orally administered competitive non-selective opioid receptor antagonist and has been studied in the PCOS population with encouraging, albeit inconsistent results. …”

Section: Miscellaneous Opioid Receptor Antagonistmentioning

confidence: 99%

Advances in Treatment Options for Polycystic Ovary Syndrome

Lathief¹,

Pal²

2012

US Endocrinology

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS.Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents-e.g., thiazolidinedionesfollowed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies with in vitro oocyte maturation. KeywordsPolycystic ovary syndrome, androgen, oral contraceptive, antiandrogen, spironolactone, finasteride, flutamide, eflornithine, insulin, metformin, thiazolidinediones, incretins, statins, acarbose, myo-inositol In this article, the authors have attempted to provide an overview of the treatment options that offer therapeutic benefit in PCOS. Treatment Options for Targeting Common Symptoms Combined Oral ContraceptivesHaving long been used as the first-line treatment in PCOS management, combined oral contraceptives (COCs) offer not just menstrual regulation and endometrial protection, but also a benefit against cutaneous stigmata of hyperandrogenism in women with PCOS. 5-7Mechanisms whereby COCs mediate improvements in PCOS-related symptoms include:• a suppression of pituitary luteinizing hormone (LH), thereby reducing the stimulant effect of LH on androgen production by the ovarian theca cells;• an increase in hepatic sex hormone binding globulin (SHBG) directly resulting from the estrogen component in the COC; the net effect is a

show abstract

Is polycystic ovary syndrome associated with high sympathetic nerve activity and size at birth?

Cited by 181 publications

References 55 publications

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women

Advances in Treatment Options for Polycystic Ovary Syndrome

Contact Info

Product

Resources

About